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Prostate Enlargement (BPH)

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Benign prostatic hyperplasia (BPH) is a common health problem that occurs when the prostate gland enlarges and is usually seen in men with aging. The prostate is located just below the bladder and surrounds the urethra. Therefore, when the prostate becomes enlarged, it can restrict urine flow and cause lower urinary tract symptoms. BPH is usually harmless and does not pose a risk of developing into cancer, but it can negatively affect quality of life.

This condition is common in men over the age of 50, and the severity of symptoms can vary from person to person. Some patients only experience mild symptoms, while others may develop severe urinary problems. With early diagnosis and appropriate treatment, the problems caused by BPH can be largely controlled.

BPH Symptoms

BPH can include a set of signs called lower urinary tract symptoms (LUTS). The most common symptoms include:

• Straining to urinate: Weak or interrupted urine flow.

• Increased frequency of urination: Frequent urination, especially at night (nocturia).

• Sudden urge to urinate: Difficulty in holding urine.

• Feeling of not being able to completely empty the bladder: Feeling of discomfort after urination.

• Pain or burning during urination: May be seen in more advanced stages.

These symptoms are not due to prostate size, but rather to the pressure the prostate puts on the urethra and changes in bladder function.

Causes and Risk Factors of BPH


The exact cause of BPH is unknown, but aging and hormonal changes are thought to play a role. Prostate tissue can grow with age, narrowing the urethra. Other factors that may increase the risk of BPH include:

Age: It is more common in men over 50 years of age.

Family history: First-degree relatives with BPH are a risk factor.

Hormonal changes: Imbalances in testosterone and estrogen levels.

Lifestyle: Sedentary lifestyle, obesity and unhealthy eating habits.


BPH Diagnosis


BPH is diagnosed by taking a detailed history, physical examination and some diagnostic tests. The methods generally used are:

Digital rectal examination (DRE): To assess the size and consistency of the prostate.

PSA test: Differential diagnosis with prostate cancer is made by measuring the prostate specific antigen level.

Uroflowmetry: A test that measures urine flow rate.

Ultrasound: To assess prostate size and amount of urine in the bladder.

Urinalysis: To rule out infection or other problems.


BPH Treatment Options


Treatment for BPH depends on the severity of symptoms and their impact on the patient's quality of life. Treatment options include:


1. Medical Treatment

Alpha blockers: Facilitate urine flow by relaxing the muscles in the urinary tract.

5-alpha reductase inhibitors: Reduce prostate volume and reduce symptoms.

Combination therapy: More effective results can be obtained by using both types of drugs together.


2. Minimally Invasive Procedures

Rezum (water vapor therapy): Steam energy is used to shrink prostate tissue.

HoLEP (Holmium Laser Enucleation): It is a minimally invasive method to remove prostate tissue with laser.


3. Surgical Treatment

TUR-P (Transurethral Prostate Resection): Surgical removal of prostate tissue that obstructs urine flow.

Open Prostatectomy: It is preferred in very large prostates.


Managing BPH with Lifestyle


People with mild symptoms can reduce the effects of BPH with lifestyle changes:

Regulating fluid intake: Limiting fluid consumption, especially before going to bed.

Reducing caffeine and alcohol consumption: May reduce bladder stimulation.

Exercising regularly: Pelvic muscle exercises can improve bladder control.


BPH is a condition that can lead to serious complications but can be effectively treated with the right approach. Early diagnosis and treatment are critical to improving the patient's quality of life in the long term.

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